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    Implementing a simplified enhanced recovery program (ERP) focusing on early ambulation and alimentation significantly reduced complications and readmissions for bowel surgery patients. This streamlined approach improved patient outcomes across a large healthcare system.

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    Area of Science:

    • Surgical outcomes research
    • Healthcare systems implementation science
    • Patient recovery protocols

    Background:

    • Enhanced recovery programs (ERPs) are known to improve surgical outcomes but face implementation challenges in large healthcare systems.
    • A simplified ERP focusing on key process steps was developed to address these challenges.

    Purpose of the Study:

    • To evaluate the impact of a simplified ERP on patient outcomes after elective bowel surgery.
    • To assess the effectiveness of focusing on early ambulation and alimentation within a large healthcare system.

    Main Methods:

    • A retrospective analysis of 5,000 adult patients undergoing elective small and large bowel operations over three years.
    • Data collection on complication, readmission, and mortality rates before and after ERP implementation.
    • Calculation of a composite score based on adherence to early ambulation and alimentation protocols.

    Main Results:

    • A 35.1% increase in the composite score was observed post-ERP implementation.
    • Significant reductions (p < .05) in overall complications, gastrointestinal complications, and pulmonary complications.
    • Significant reductions in patient readmission rates were also noted.

    Conclusions:

    • A system-wide, simplified ERP focusing on early ambulation and alimentation is effective in reducing complications and readmissions.
    • This approach demonstrates feasibility and positive impact on outcomes for elective bowel surgery patients.
    • Simplified ERP protocols can overcome implementation barriers in large healthcare settings.